Table 5.

Incidents reported while scribe involved in care

Incident	Incident summary	Error categories
1	Scribe booked follow-up appointment for patient. IT permissions for appointment booking allowed scribe data entry (scribe believed appointment to be booked) but did not allow appointment to be actioned	Handover; investigation
2	Duplicate radiography requests ordered by physician; scribe identified that patient did not need second study and cancelled it. Doctor multi-tasking	Investigation
3	Paediatric patient kicking expensive medical equipment off bed. Scribe removed equipment to avoid it being broken. Rest of team focusing on other tasks at the time	Equipment
4	Physician consulting with patient while nebuliser running. Scribe could not hear most of consultation and documented it incorrectly. Physician corrected documentation at editing/verification of scribe work stage	Documentation; medication
5	Scribe was threatened and almost assaulted by patient during consultation. No basic violence avoidance training in scribe course. Did not realise that they could walk out of room if threatened	Violence
6	Scribe left patient name as “John Doe” in medical record rather than understanding that it should be edited out once patient was identified. Physician did not identify error at verification stage. No process had been developed for scribe or physician as to how to deal with time critical patients and need for patient’s name to enable IT systems to function. Scribe identified error later and corrected chart	Patient identification
7	Physician unable to see electronic triage notes at bedside. Young child had upper limb injury. Stressed mother showed physician uninjured limb for examination and radiography. Scribe could see electronic triage in room and intervened, cancelling incorrect radiography. They established that other limb was injured. Radiograph confirmed fracture	Treatment; investigation
8	Trauma patient evaluated by physician after paramedics had handed over to nurses. Patient had dementia and could not recall events of day clearly. Nurse handover to physicians omitted details of trauma. Scribe read written ambulance report (printed 30 min after physician consultation) and identified important features of trauma event that changed management	Transfer; handover; documentation
9	While physician was charting drugs for patient by using pill packets brought from home, scribe collected another patient’s drugs and placed them in same pile. These were incorrectly recorded in original patient’s chart. Error was realised later when second drug chart was being written, and error was corrected by physician	Patient identification; medication
10	Scribe assigned physician to patient electronically. Physician did not realise this. Scribe did not prompt physician. After prolonged patient wait for physician, error was identified	Patient identification; prolonged length of stay; documentation
11	Specialist attended ED to consult on patient. Specialist read results of wrong patient and made management plans based on this interpretation. Scribe read plan, realised error, and advised physician. Error corrected	Patient identification; investigation
12	CT ordered for patient. Patient location changed in ED after order. Porter took wrong patient from original location to CT without complete identity checks. Scribe saw this happening, intervened, and brought wrong patient back from radiology before scan	Patient identification; investigation
13	Physician ordered CT on EMR while wrong patient chart was opened. Scribe observed this, intervened, and corrected error	Patient identification; investigation
14	Scribe watched patient with a multi-resistant organism infection be discharged from ED. Just before new patient occupied cubicle, scribe intervened to ask why room had not been cleaned to decontaminate for this organism. Room cleaned before new patient occupation	Bed allocation
15	Scribe and doctor underestimated severity of patient’s presentation. Nurse correctly identified deterioration and arranged for patient to be admitted	Failure to recognise severity
16	Scribe ordered radiography for wrong patient. Scribe identified error and intervened. Scribes are not licensed to order imaging, and this represents scope creep for role	Patient identification; investigation

CT=computed tomography; ED=emergency department; EMR=electronic medical record; IT=information technology.